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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608972
Report Date: 12/18/2025
Date Signed: 12/18/2025 12:39:50 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/07/2024 and conducted by Evaluator Quoc Huynh
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20240807145031
FACILITY NAME:ANTHEM SENIOR CAREFACILITY NUMBER:
197608972
ADMINISTRATOR:GHAZARYAN, SOFIAFACILITY TYPE:
740
ADDRESS:12813 FRIAR STREETTELEPHONE:
(818) 445-0993
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91606
CAPACITY:6CENSUS: 6DATE:
12/18/2025
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Sofiya Ghazaryan - AdministratorTIME COMPLETED:
12:50 PM
ALLEGATION(S):
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Staff physically assaulted resident which resulted in injuries
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Quoc Huynh conducted an unannounced subsequent complaint visit to deliver findings for the above allegation. The LPA arrived at 12:20PM and met with the Administrator Sofiya Ghazaryan and explained the reason for the visit. Entrance interview conducted.

On 08/08/2024, LPA Christine Yee conducted an initial complaint visit at 11:45AM. Between 12:01PM and 2:43PM, LPA Yee interviewed the Administrator, two (2) staff, two (2) residents, and attempted one (1) resident interview. Additionally, LPA Yee conducted a safety tour and observed the facility’s food supply.

Report Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 29-AS-20240807145031
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: ANTHEM SENIOR CARE
FACILITY NUMBER: 197608972
VISIT DATE: 12/18/2025
NARRATIVE
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On 11/19/2025, LPA Huynh conducted a subsequent visit. Between 10AM and 10:40AM, LPA Huynh conducted a physical plant tour, interviewed the Administrator, one (1) staff, two (2) residents, and attempted four (4) resident interviews. Beginning at 11:09AM, the LPA conducted a medication review.

During today’s visit, the LPA and Administrator conducted a physical plant tour at 12:28PM, and no immediate concerns were observed. The following was then determined:

Allegation: “Staff physically assaulted resident which resulted in injuries”

It was reported that facility staff physically assaulted Resident #1 (R1), allegedly resulting in lacerations and bruises. Interview with four (4) residents revealed that staff treat them respectfully and meet their care needs. They denied experiencing physical abuse and stated they had not observed staff mistreating R1. Staff were observed to assist R1 with showers, feeding, and incontinence care. R1 was unable to participate in an interview due to medical condition. Interview with staff stated they provide care in accordance with residents’ care plans and requests for additional accommodation. They confirmed they do not yell at the residents, though they raise their voices when communicating with residents who are hard of hearing. Staff further reported they do not become frustrated or physical with residents.

Physician’s Report dated 02/04/2025 documented R1 to be non-ambulatory with bed bound status and a diagnosis of Huntington’s Disease. Hospice Care Plan initiated on 06/16/2025 indicated R1 remained bed bound and received two (2) Home Health Aide visits per week. R1’s Appraisal/Needs and Services Plan dated 01/28/2025 reported R1 had limited functioning and required full assistance with activities of daily living.

Based on interview and record review, although the allegation may have happened or is valid, there is not sufficient evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed UNSUBSTANTIATED at this time.

No deficiency cited. Exit interview conducted. A copy of the report was reviewed and provided.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2